Obsessive-compulsive disorder (OCD) has been one of the main research topics of our unit for several years. We are interested in many different aspects of the disorder, from basic research (e.g., memory, information processing, cognitive biases), which aims at a better understanding of the etiology and maintenance of OCD, to the development and evaluation of specific interventions.
The therapeutic and self-help interventions developed by our unit are based upon the findings of basic research. For the results of completed projects, please see the reference list below. Selected projects are outlined in the following sections.
Memory, Metamemory, and Responsibility
In a research project supported by the German Research Foundation we investigated a possible link between visuospatial dysfunctions and nonverbal memory with OCD symptomatology. The results provided no evidence for the existence of specific spatial or non-verbal memory deficits in OCD (Moritz et al., 2005; see also Jelinek, Moritz, Heeren, & Naber, 2006). Further studies were based on the theory that OCD patients display abnormalities in metamemory (e.g., response confidence, subjective appraisal of one’s performance skills) rather than in memory accuracy. In these studies, OCD patients and healthy controls did not differ with regard to source memory (i.e., memory of the source of information), response confidence, or subjective vividness of stored memory episodes (Moritz, Jacobsen, Willenborg, Jelinek, & Fricke, 2006; Moritz, Kloss, Jahn, Schick, & Hand, 2003; Moritz, Ruhe, Jelinek, & Naber, 2009). A decrement of metamemory occurred only under conditions in which subjective responsibility was inflated (Moritz et al. 2007).
Negative priming is usually regarded as a parameter of cognitive inhibition. In contrast to previous reports by others, we did not find reduced negative priming in OCD (Moritz, Kloss, & Jelinek, 2010). Moreover, we found similar processing of subordinate local vs. higher-order global structures using a local-global paradigm (Moritz, Wendt, Jelinek, Ruhe, & Arzola, 2008). Further studies employed tests that are thought to be sensitive to the orbitofrontal cortex (e.g., the delayed alternation task (DAT); Moritz, Hottenrott, et al., 2009; the object alternation task (OAT); Moritz, Jelinek, Hottenrott, Klinge, & Randjbar, 2009).
To further assess the characteristics of information processing in patients with OCD, we used the following paradigms: inhibition of return paradigm (IOR) (Moritz, von Mühlenen, Randjbar, Fricke, & Jelinek, 2009), emotional Stroop test (EST) (Moritz, Fischer, et al., 2008), retrieval-induced forgetting paradigm (RIF) (Jelinek, Rietschel, Kellner, & Moritz, 2012), and directed forgetting paradigm (DF) (Moritz, Rietschel, Jelinek, & Bäuml, 2011).
Moreover, we were able to find initial evidence in an online study that OCD participants are more likely than healthy controls to process ambiguous words (i.e., homographs) in an OCD-related or negative context (Jelinek, Hottenrott, & Moritz, 2009).
These characteristics of biased information processing in OCD are addressed in “association splitting”, a technique developed by our group designed to reduce obsessive thoughts (Moritz, Jelinek, Klinge, & Naber, 2007). For more information, please click on the Therapy tab above.
Thinking Styles/ Cognitive Biases in OCD
Cognitive biases (e.g., inflated sense of responsibility or overestimating the probability of danger) and personality styles (e.g., perfectionism, intolerance of ambiguity) play a special role in the development and maintenance of compulsions. We have developed a self-help manual consisting of 14 modules addressing these cognitive biases as well as typical OCD-related concerns. In the manual, we use results of our own studies on OCD-relevant thinking styles (e.g., Moritz, Alpers, et al., 2011; Moritz & Jelinek, 2009) as well as recent metacognitive approaches in the treatment of cognitive biases. The self-help manual has been positively evaluated in comparison to a waitlist control group in an online study (Moritz, Jelinek, Hauschildt, & Naber, 2011), and the second edition is now available (Moritz & Hauschildt, 2011). A subsequent study, funded by the Bundesministerium für Bildung und Forschung, confirmed the feasibility and effectiveness of the program (Hauschildt, Schröder & Moritz. 2016). For more information, please click on the Therapy tab above.
- Barbara Cludius, M.Sc. Psych.
- Dr. Marit Hauschildt
- Dipl.-Psych. Birgit Hottenrott
- PD Dr. Lena Jelinek
- Prof. Dr. Steffen Moritz
- Dr. Charlotte Wittekind
- Dr. Andrea Ertle (Humboldt University Berlin, Germany)
- Dr. Ansgar Feist (Siegburg, Germany)
- PD Dr. Susanne Fricke (University of Hamburg, Germany)
- Prof. Dr. Iver Hand (Falkenried, Hamburg, Germany)
- Prof. Dr. Norbert Kathmann (Humboldt University Berlin, Germany)
- Prof. Dr. Michael Kellner (Medical Park Clinic Chiemseeblick, Bernau-Felden, Germany)
- PD Dr. med. Michael Rufer (University of Zurich, Switzerland)
- Dr. Alexander F. Schmidt (Rheinische Friedrich-Wilhelms-Universität Bonn, Germany)
- Prof. Dr. Ulrich Voderholzer (Schön Klinik Roseneck, Prien am Chiemsee, Germany)
- Prof. Dr. Michael Wagner (Department of Psychiatry, Bonn, Germany)
Memory, Metamemory, and Responsibility
Jelinek, L., Moritz, S., Heeren, D., & Naber, D. (2006). Everyday memory functioning in obsessive-compulsive disorder. Journal of the International Neuropsychological Society, 12, 746-749.
Moritz, S., Jacobsen, D., Willenborg, B., Jelinek, L., & Fricke, S. (2006). A check on the memory deficit hypothesis of obsessive-compulsive checking. European Archives of Psychiatry and Clinical Neuroscience, 256, 82-86.
Moritz, S., Kloss, M., Jacobsen, D., Kellner, M., Andresen, B., Fricke, S., Kerkhoff, G, Sieman, C. & Hand, I. (2005). Extent, profile and specificity of visuospatial impairment in obsessive-compulsive disorder (OCD). Journal of Clinical & Experimental Neuropsychology, 27, 795-814.
Moritz, S., Kloss, M., Jahn, H., Schick, M., & Hand, I. (2003). Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder. Cognitive Neuropsychiatry, 8, 261-272.
Moritz, S., Ruhe, C., Jelinek, L., & Naber, D. (2009). No deficits in nonverbal memory, metamemory and internal as well as external source memory in obsessive-compulsive disorder (OCD). Behaviour Research and Therapy, 47, 308-315.
Moritz, S., Wahl, K., Zurowski, B., Jelinek, L., Fricke, S., & Hand, I. (2007). Enhanced perceived responsibility decreases metamemory but not memory accuracy in obsessive-compulsive disorder (OCD). Behaviour Research and Therapy, 45, 2044-2052.
Jelinek, L., Hottenrott, B., & Moritz, S. (2009). When cancer is associated with illness but no longer with animal or zodiac sign: Investigation of biased semantic networks in obsessive-compulsive disorder (OCD). Journal of Anxiety Disorders, 23, 1031-1036.
Jelinek, L., Rietschel, L., Kellner, M., & Moritz, S. (2012). The effect of practice on the recall of salient information in obsessive-compulsive disorder. Psychiatry Research, 198, 89-93.
Moritz, S., Fischer, B. K., Hottenrott, B., Kellner, M., Fricke, S., Randjbar, S., & Jelinek, L. (2008). Words may not be enough! No increased emotional Stroop effect in obsessive-compulsive disorder. Behaviour Research and Therapy, 46, 1101-1104.
Moritz, S., Hottenrott, B., Randjbar, S., Klinge, R., Von Eckstaedt, F. V., Lincoln, T. M., & Jelinek, L. (2009). Perseveration and not strategic deficits underlie delayed alternation impairment in obsessive-compulsive disorder (OCD). Psychiatry Research, 170, 66-69.
Moritz, S., & Jelinek, L. (2011). Further evidence for the efficacy of association splitting as a self-help technique for reducing obsessive thoughts. Depression & Anxiety, 28, 574-581.
Moritz, S., Jelinek, L., Hottenrott, B., Klinge, R., & Randjbar, S. (2009). No evidence for object alternation impairment in obsessive-compulsive disorder (OCD). Brain and Cognition, 69, 176-179.
Moritz, S., Jelinek, L., Klinge, R., & Naber, D. (2007). Fight fire with fireflies! Association splitting: A novel cognitive technique to reduce obsessive thoughts. Behavioural and Cognitive Psychotherapy, 35, 631-635.
Moritz, S., Kloss, M., & Jelinek, L. (2010). Negative priming (cognitive inhibition) in obsessive-compulsive disorder (OCD).Journal of Behavior Therapy and Experimental Psychiatry, 41, 1-5.
Moritz, S., Rietschel., L., Jelinek, L., & Bäuml, K.-H. (2011). Are patients with obsessive–compulsive disorder generally more doubtful? Doubt is warranted! Psychiatry Research, 189, 265-269.
Moritz, S., & von Muhlenen, A. (2005). Inhibition of return in patients with obsessive-compulsive disorder. Journal of Anxiety Disorders, 19, 117-126.
Moritz, S., & von Muhlenen, A. (2008). Investigation of an attentional bias for fear-related material in obsessive-compulsive checkers. Depression and Anxiety, 25, 225-229.
Moritz, S., Von Muhlenen, A., Randjbar, S., Fricke, S., & Jelinek, L. (2009). Evidence for an attentional bias for washing- and checking-relevant stimuli in obsessive-compulsive disorder. Journal of the International Neuropsychological Society, 15, 365-371.
Moritz, S., Wendt, M., Jelinek, L., Ruhe, C., & Arzola, G. M. (2008). No disadvantage for the processing of global visual features in obsessive-compulsive disorder. Journal of the International Neuropsychological Society, 14, 489-493.
Thinking Styles and Cognitive biases
Hauschildt, M., Schröder, J., & Moritz, S. (2016). Randomized-controlled trial on a novel (meta-) cognitive self-help approach for obsessive-compulsive disorder ("myMCT"). Journal of Obsessive-Compulsive and Related Disorders, 10, 26-34.
Moritz, S., Alpers, G. W., Schilling, L., Brooks, A., Willenborg, B., & Nagel, M. (2011). Larger than life: Overestimation of the object size is moderated by personal relevance in obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 481-487.
Moritz, S., & Hauschildt, M. (2011). Erfolgreich gegen Zwangsstörungen: Metakognitives Training - Denkfallen erkennen und entschärfen [Successfully overcoming obsessive-compulsive disorder: Metacognitive training – Identifying and mitigating cognitive distortions.] (2nd Ed.). Berlin, Germany: Springer.
Moritz, S., & Jelinek, L. (2009). Inversion of the “unrealistic optimism” bias contributes to overestimation of threat in obsessive-compulsive disorder. Behavioural and Cognitive Psychotherapy, 37, 179-193.
Moritz, S., Jelinek, L., Hauschildt, M., & Naber, D. (2011). How to treat the untreated! Effectiveness of a self-help metacognitive training program (myMCT) for obsessive-compulsive disorder (OCD). Dialogues in Clinical Neuroscience, 12, 209-220.